Insurer Targeted HIV Carriers for Policy Cancellations

Misspelling in the headline. Please fix that Rcade.

"You obviously don't undestand how the insurance industry works"

-Sniverly

So he sued and won $10,000,000.

When Obamacare is the rule of the land, can I sue the former POTUS? How about Pelosi? Who do we sue, when it's the federal government going to be cutting the checks, and the government has to allow itself to be sued?

I understand fine, Lettucepissandmoan

perhaps someone can explain the difference between "revoked" and "cancelled" to you.

it's the same at the end of the day but it is a practice used by insurers in their "free look" period by which an insurer goes back to verify all information given to them was 100% accurate.

It appears that Fortis was being too aggressive and targeted HIV patients.

can I sue the former POTUS?

So now you are pro "frivolous" lawsuits. Good to know.

but it is a practice used by insurers in their "free look" period by which an insurer goes back to verify all information given to them was 100% accurate.

Fortis canceled Mitchell's health insurance based on a single erroneous note from a nurse in his medical records that indicated that he might have been diagnosed prior to his obtaining his insurance policy. When the company's investigators discovered the note, they ceased further review of Mitchell's records for evidence to the contrary, including the records containing the doctor's diagnosis.

Nettles also suggested that Fortis should have realized the date in the note was incorrect: "Not only did Fortis choose to rely on one false and unreliable snippet of information containing an erroneous date to the exclusion of other information which would have revealed that date to be erroneous, Fortis refused to conduct any further investigation even after it was on notice the evidence which aroused its suspicion to be false," the judge noted.

So please tell us, oh insurance guru, if they verify all information given to them was 100% accurate, why did they stop any further investigation after they found the one note that was supported their decision?

Kind of hard to be 100% accurate when you stop looking halfway through.

"Who do we sue, when it's the federal government going to be cutting the checks, and the government has to allow itself to be sued?"

Who are you trying to fool with your bull shit???
You know as well as I do that it will still be private insurance companies cutting checks.
Time to move on to the next battle, I think y'all have already lost this one. Time to learn new lies and talking points about other issues.

Amazing how much faith you liberals have in government. I wonder if that will be true when Republicans run things again. And, eventually, conservatives, who know that you can't run deficits forever.

"conservatives, who know that you can't run deficits forever."
#8 | Posted by rightisright

Let me know when Republicans plan on nominating that person because they sure haven't yet.

So he sued and won $10,000,000.
When Obamacare is the rule of the land, can I sue the former POTUS? How about Pelosi? Who do we sue, when it's the federal government going to be cutting the checks, and the government has to allow itself to be sued?
#3 | Posted by rightisright at 2010-03-17 02:30 PM

Whom is going to be sued by shareholders? Which individual instituted the "rescission" policy? Let's examine the data:

"There was evidence that Fortis' general counsel insisted years ago that members of the rescission committee not record the identity of the persons present and involved in the process of making a decision to rescind a Fortis health insurance policy," Nettles wrote.

Elsewhere in his order, Nettles noted that there were no "minutes of actions, votes, or any business conducted during the rescission committee's meeting."

I understand fine, Lettucepissandmoan
perhaps someone can explain the difference between "revoked" and "cancelled" to you.
it's the same at the end of the day but it is a practice used by insurers in their "free look" period by which an insurer goes back to verify all information given to them was 100% accurate.
It appears that Fortis was being too aggressive and targeted HIV patients.
#4 | Posted by eberly at 2010-03-17 02:31 PM

There is the fact that software targeted 100% of their HIV-positive clients. They were not "too aggressive", but singular and motivated by profit alone. This is not debatable.

What might be is how investigations are performed - according to Fortis they had ample information to pursue their rescission target. If HIV alone can be a determined factor why not carpal tunnel or near-sightedness? I believe that their end goal with the practice of "rescission" is the arbitrary annexing of individuals from coverage with little medical evidence supporting these decisions. So long as they withhold medical evidence their interpretation of their investigation was sufficient for their ultimate decision to revoke coverage. By not holding minutes or recording whom made the determination there is no one person "at fault" and no persons for investigators to examine. It seems obvious that Fortis is a scam.

#10. I don't even think it's bad to target HIV clients to do an investigation to see if there was fraud. That's an expensive disease to treat, and if there was demonstrable fraud, then it would make sense to audit those files (and any other big-ticket disease).

The problem is if the investigation is bogus and the revocation based on flimsy evidence.

#10. I don't even think it's bad to target HIV clients to do an investigation to see if there was fraud. That's an expensive disease to treat, and if there was demonstrable fraud, then it would make sense to audit those files (and any other big-ticket disease).
The problem is if the investigation is bogus and the revocation based on flimsy evidence.
#11 | Posted by somoco at 2010-03-17 08:12 PM

Obviously the real problem is that Fortis was able to perform this "rescission" with such extreme prejudice and selective policy handling that nobody wants to take the blame. Isn't that why there are no minutes for the judges to have read?

Flimsy evidence? Try ZERO evidence. That's what private health insurance industry has come to.

Trust me, after a few multimillion dollar verdicts, their business practice will change. a govt. run plan will have no such safeguard.

"When Obamacare is the rule of the land, can I sue the former POTUS? How about Pelosi? Who do we sue, when it's the federal government going to be cutting the checks, and the government has to allow itself to be sued?
#3 | Posted by rightisright"

No wonder this shitstain and some others are opposed to this bill. They actually believe the false propaganda spouted by Fox News, etc. If you're this ignorant, you should lose the right to vote.

Monte,

Not to worry. Once the DEATH PANELS get cranked up on Monday, the first to go in the rendering vats will be the Cluserfox viewers.

Just think about all the nice new Bio-diesel those people will provide. They can't be called worthless any more!!!

Tip for all you guys with diesel vehicles: Bio-diesel is good stuff, just remember to alternate every 4th tank with petro-diesel.

I hear that Republican-bio-diesel is going to be about $.40/gallon cheaper than petro-diesel. Keep in mind the you'll get about 5% lower mileage from the Death Panel produced diesel due to the low quality of the feed stock, but it still works out to more miles per dollar with the discounted price.

Look for the new pumps at your Chevron and Shell stations starting in about a month.

Amazing how much faith you liberals have in government. I wonder if that will be true when Republicans run things again. And, eventually, conservatives, who know that you can't run deficits forever.

#8 | Posted by rightisright at 2010-03-17 03:24 PM | Reply | Flag: THIS is what happens to your brain when you eat your own turds

Trust me, after a few multimillion dollar verdicts, their business practice will change. a govt. run plan will have no such safeguard.

You're overlooking the fact that a government plant won't be pressured to drop costly patients to please Wall Street.

Not only that, a government plan that nixes this whole "pre-existing condition" nonsense will bring the focus back to delivering health care.

Fortis, a health insurance company, chose to spend their resources coming up with clever ways to not deliver health insurance. The exact opposite of their stated mission.

"Amazing how much faith you liberals have in government. I wonder if that will be true when Republicans run things again."

Actually, it's very hard for us libs to have faith in anything that involves Republicans.

P.S.: One thing I wish was in the 2500 or so pages of the health bill - and almost certainly isn't:

A requirement that insurance company employees at every level receive no more coverage and no better treatment than they accord their insureds, that they are subject to precisely the same standards for coverage, exclusion, cancellation and claim denial as everyone they cover.

Obviously, I will be able to buy a baby unicorn at Petco before this happens, but wouldn't it be nice to see a little equality here?

So please tell us, oh insurance guru, if they verify all information given to them was 100% accurate, why did they stop any further investigation after they found the one note that was supported their decision?

obviously Fortis didn't do that. they were clearly in the wrong.

what the fuck? did you expect me to defend this behavior?

I was explaining the process. If the claimant had, in fact, withheld his knowledge of his HIV when he applied then Fortis is within their rights to revoke coverage.

that wasn't the case here.

#8 | Posted by rightisright at 2010-03-17 03:24 PM | Reply | Flag: THIS is what happens to your brain when you eat your own turds

#17 | Posted by donnerboy

I've noticed dinnerboy has a fascination with cerebri and anatomy---how would he know what would happen to RIR's brain unless he indulged himself with excrement---his moniker, dinnerboy, appears to be apropos (after lunch, dinnerboy, look up the definition).

I was explaining the process. If the claimant had, in fact, withheld his knowledge of his HIV when he applied then Fortis is within their rights to revoke coverage.

"Within their rights." Interesting turn of phrase.

Let's have a look at the implications here, some "what ifs."

Let's say he did know he was HIV+.
Let's say he disclosed it too.
Let's say Fortis denied him coverage for obvious bean-counter reasons.

How then does someone with HIV get health insurance?

To put it another way,

If the claimant had, in fact, withheld his knowledge of his HIV when he applied then Fortis is within their rights to revoke coverage.

Do you defend that status quo? On what basis? Surely not a moral one.

Not that I believe in Jesus, nor do I expect to tug at your heart-strings with this sob story, but from a public policy basis... Who Would Jesus Insure?

Who gets insurance, who doesn't, and why? Shall we only insure the profitable? Can we take that to the next level and disenroll the merely marginally profitable? Why or why not?

Who gets insurance, who doesn't, and why? Shall we only insure the profitable? Can we take that to the next level and disenroll the merely marginally profitable? Why or why not?

If it were a known fact that we could all walk around waiting for ourselves to get sick before we purchase health insurance then that is exactly what would happen.

People would wait until after they get sick before they go get coverage.

That won't work.

It is the equivilent of waiting until your house is on fire before you secure coverage.

How on earth do you not understand that concept?

I would suggest you come with another line of thinking. the one you have is a not sound.

Are you seriously suggesting that people should go without insurance, wait until they get sick, and then be able to go purchase insurance and you actually expect an insurance company to accept those applicants??

If the premiums were $15,000 a month, it still wouldn't be enough for people like that.

Good grief that makes no sense and you are suggesting something that our govt (despite what you think is in this health care bill) is NEVER really going to do.

How then does someone with HIV get health insurance?

they can't. that person becomes a charity case for the govt, the hospital and the rest of us.

remember, we insureds already pay for the uninsured already.

interesting though.....why was the guy going without insurance and then, after contracting HIV, all of the sudden wants insurance?

So he sued and won $10,000,000.

When Obamacare is the rule of the land, can I sue the former POTUS? How about Pelosi? Who do we sue, when it's the federal government going to be cutting the checks, and the government has to allow itself to be sued?

#3 | Posted by rightisright

Dude, you can't sue!

However, you will always have a place in government housing, by yourself, your wife will be in another dorm and your kids will be placed in a state home for kids with unfit parents.

You will be sitting there thinking that if you had a chance to go back in time to today and stop Obamacare...

Actually, I volunteer to serve on the death panels. When liberals finally succeed in giving us single payer, and the ebb-and-flow of Congressional control eventually puts conservatives in charge of healthcare spending, it will be time to discriminate based on lifestyle choices. All to save taxpayers' dollars, that is. No more fatties, no more gays, no more alchies, no more coverage for anyone with a history of drug abuse or smokers.

Just like in the UK, right now. We'll have balanced budgets again, and why should healthy people subsidize the lifestyles of people who have gay sex? If Philly can pass extra taxes on sugary drinks, logic should tell you where the other dominoes will fall.

So? They made the decision to engage in behavior that exposed them to the disease. Why should I have to pay for (or any of you) someone that makes a bad decision?

The insurance company kicking the HIV people out, reduces the cost for everyone that is making good decisions about their lives.

Shouldn't people be held accountable for the decisions that they made?

"why should healthy people subsidize the lifestyles of people who have gay sex?"

And the 'phobe rages again. Tell us RiR, if gays were in the majority, should they have the right to outlaw treatments for heterosexual diseases?

"We'll have balanced budgets again"

Posts the guy who argued against balanced budgets when the President had an (R) after his name.

"why should healthy people subsidize the lifestyles of people who have gay sex?"

Fair enough, but why stop there?

Why should healthy people subsidzie the lifestyles of people who:

smoke
drink
do drugs
drive cars
eat too much fast food
have tons of kids they cannot afford
don't work
major in fields they know they will not find work in

Kind of hard to be 100% accurate when you stop looking halfway through.

#6 | Posted by 726

If you buy a bag of spuds and find a turd in the bag, what would you do, keep looking for more turds just to be sure the one you found was a smelly one?

And the 'phobe rages again. Tell us RiR, if gays were in the majority, should they have the right to outlaw treatments for heterosexual diseases?
* * * *

No. But they would anyway. AIDS already commands a far larger portion of investment research dollars than its proportion of sufferers should suggest.

I'm not a 'phobe. Whatever gays wanna do, let them do. But don't come running up to the rest of us and ask us to pay for it. Same goes for everything else, whether it be Wall Street risk, having children, getting married, buying a car or a house, or running for political office. I'll stay out of your bedroom and boardroom, and you stay out of my wallet. Fair 'nuff?

If you buy a bag of spuds and find a turd in the bag, what would you do, keep looking for more turds just to be sure the one you found was a smelly one?

#32 | Posted by Sniper at 2010-03-19 12:35 PM | Reply | Flag: FRONT-RUNNER FOR DUMBEST POST OF THE WEEK

Why should healthy people subsidzie the lifestyles of people who:

smoke
drink
do drugs
drive cars
eat too much fast food
have tons of kids they cannot afford
don't work
major in fields they know they will not find work in

#31 | Posted by kanrei

Exactly what I have been saying for years. Their life choices shouldn't be my concern. They made the choices and they should pay for them.

eat too much fast food

Today was the day that once a year during lent I agree to eat at Long John Silvers.

I feel like I need a stint put in.

"How then does someone with HIV get health insurance?"

they can't. that person becomes a charity case for the govt, the hospital and the rest of us.
remember, we insureds already pay for the uninsured already.
interesting though.....why was the guy going without insurance and then, after contracting HIV, all of the sudden wants insurance?
#26 | Posted by eberly at 2010-03-19 10:14 AM

So, this issue isn't at all about "morals" or "values" stuff, it's a simple matter of numbers? In this instance, that seems a fairish assessment for your concern over not insuring inoperable folks, birth defects and such - if they already automatically become eligible for our government to finance their medical needs. But that's not really happening - most of them need to fight for their turn at whatever trough you envision sick and dying people fighting over. Your side uses pig-analogies a lot. It's slightly disturbing. I just wanted to be certain it's the perceived cost in dollars that is strictly what opines ya'll.

There are monetary abuses everywhere and all of them are unfair burdens. The dollar is buying less and less medical coverage by the day due to monetary value versus medical costs. The "growing return" rationale being offset by alleged research and development expenditures including proprietary manufacturing contracting and intellectual proprietization whatnotary. Some of that is legitimate, but considering the consequences thusfar in allowing these "values" to be placed on access to what should otherwise be cheap and uncomplicated is a concern. Under private business we cannot necessarily have that kind of operations premise and are often victimized by simple greed and data hording of these privatizers. We've all heard about the practice of privately funded research foregoing other avenues of discovery while focusing research toward an "end product", then legally owning the research discoveries? This is inevitably producing a plethora of designer drugs, some are literally de-stabilizing society, others augment inter-relative behavior - like attitudes towards casual drug use versus prescribed, etc. - but we also experience terrible side-effects. Factual cost is a major one. We lose valuable individuals steadily due to unfair persecution of the most competitive and particularly effective drug, marijuana. Incarceration trends toward further destabilization and inevitably criminal behavior. Staying out from jail is the best way to not become a criminal, like televangelism discourages religious study - they co-operate both ways. In this instance it's not feasible for private drugs to compete with pot grown in a closet versus their custom Chinese warehouse/laboratories. This preferential treatment magically allows the health insurance companies deny coverage and medical procedures based entirely upon specific drugs recognized. In doing so, they have effectively policed out the marijuana "abusers" in society and simultaneously deprived them of what they would allegedly benefit the most from - medical coverage which includes the very drugs in competition against pot. Our drug policies are a ridiculous cycle of denial through alleged self-incrimination.

But it's obviously more nuanced an issue than saying everyone "abuses", but everyone who uses a manufactured drug competitor is risking losing access to manufactured drugs which is also relative to medical procedures which is ultimately a legal determination made by an insurance provider.

The cost in human workers, operations lost, legal costs it's not worth it for the taxpayer to incarcerate marijuana users whatsoever. The benefit to legalization is more competition with drug manufacturers. How can that be bad?

We should also have 100% understanding of the general government budget at all times, online. This budget office paid to "calculate" should be entirely held accountable (;]) and their activities most especially should be made available online for everyone to peruse. Our mutual interests are being manipulated without our consent, imposing future dependencies.

Sniper,

Exactly what I have been saying for years. Their life choices shouldn't be my concern. They made the choices and they should pay for them.

Which choice did I make to get MS?

My point of course being that sometimes people get hit by life no matter what they do. As an ethical person is it not your responsibility to help those in need? No matter the reason for the need, but especialy in a situation where there was no reason except life deciding to screw with someone? Or do you have no ethical responsibility to your fellow man?

Sniper,
"Exactly what I have been saying for years. Their life choices shouldn't be my concern. They made the choices and they should pay for them."

Which choice did I make to get MS?
My point of course being that sometimes people get hit by life no matter what they do. As an ethical person is it not your responsibility to help those in need? No matter the reason for the need, but especialy in a situation where there was no reason except life deciding to screw with someone? Or do you have no ethical responsibility to your fellow man?
#39 | Posted by TaoWarrior at 2010-03-19 04:03 PM

Our medical focus is apparently on limiting access to research and privatizing access. It's abusive and offensive, but extraordinarily free-market. What are the most promising avenues both known and presumed? Neuromimetic Dutch Brothers or do we use the old peanut butter spackle? But seriously, what retards the degeneration?

Presumed degeneration. I know nothing little to about the experience.

AWESOMENESS!

Or do you have no ethical responsibility to your fellow man?

#39 | Posted by TaoWarrior

You have no ethical responsibility to your fellow man.

Your beliefs are your own. Stop forcing your religion on the rest of us

-- the athiests.

"Or do you have no ethical responsibility to your fellow man?
#39 | Posted by TaoWarrior"

You have no ethical responsibility to your fellow man.
Your beliefs are your own. Stop forcing your religion on the rest of us
-- the athiests.
#43 | Posted by Petrous at 2010-03-19 04:31 PM

Oh, Nigerian please! We are ALL human, one global tribe, many, many children.

I think that TaoW didn't sin hisself into a thus incurable malady?

Are you seriously suggesting that people should go without insurance, wait until they get sick, and then be able to go purchase insurance and you actually expect an insurance company to accept those applicants??
If the premiums were $15,000 a month, it still wouldn't be enough for people like that.
that person becomes a charity case for the govt, the hospital and the rest of us.
remember, we insureds already pay for the uninsured already.

Well Eberly I think we're both preaching to each others choir here.
The problem with the "charity cases" is they end up costing us more than insuring them would have cost us in the first place. We need to find some way to buy them insurance, like we do with Medicare. There has to be some way of fixing the cost problem of the uninsured that isn't susceptible to the not-buying-until-you-need-it moral hazard you foresee. Mandatory coverage seems the only way. The free market has no motivation to solve this problem -- in point of fact it's created this problem in pursuit of profit. Insurance is mandated if you drive a car (even though many go without), or by the bank if you pay a mortgage on a home, so it can be done. Obviously if someone isn't receiving income you can't deduct it from their check, but most people do receive some sort of income.
I don't believe that too many would not buy until they needed it. Many people actually do the right thing owing to some self-actualized sense of right and wrong. Most people don't just blast through red lights when noone is around.

Today was the day that once a year during lent I agree to eat at Long John Silvers.
I feel like I need a stint put in

Either a harmless typo, the chemicals in the tartar sauce have addled your brain, or I'm very surprised you don't know it's "stent." en.wikipedia.org

So? They made the decision to engage in behavior that exposed them to the disease. Why should I have to pay for (or any of you) someone that makes a bad decision?

Does this mean I shouldn't have to pay the medical bills for our wounded soldiers coming home? After all, they chose to engage in the risky behavior of joining the military. Why should I have to pay for their bad decisions?

"I'm not a 'phobe."

Riiiiiiiiiiight.

You just rail against gays at every turn, and when called to question about your rants, ultimately claim they should have the right to be just as unhappily married as you were.

I rail against everyone looking for a handout.

We are ALL human, one global tribe, many, many children.

#44 | Posted by redlightrobot

One groups' beliefs should become law of the land?
That is what is said about the religious believers all the time.

Don't force your religion on us.

So, your ethics against another.

No, we do not have a responsibility to our fellow man.

The only thing that matters in the land is legal or illegal, not right and wrong.

The only thing that matters in the land is legal or illegal, not right and wrong.

Not quite. Illegal only matters if you get caught, and don't have good enough lawyers.

Additionally, belief alone does not constitute religion. I believe I just ate a ham sandwich. That's not religion.

If you told me everyone should eat ham sandwiches, that's what you believe, but I don't have to believe it, too.

I remember listening to one of those 'dear abby' shows on the radio.

I could say that at least once a week I heard 'abby' tell the person they aren't responsible for someone else.

People always said they did things because of what someone else felt, said, didn't say, etc.

So, they felt they HAD to.

Taking care of your fellow man? That's personal and a belief that differs from each person as to the extent.

If someone falls in the street, having tripped on the curb, I would have helped them up.

After a lawsuit, people became afraid to help someone up.

The choice of aid can be limited by others and by ourselves.

The sense of General Welfare falls there, too. Where do you draw the line.

I hear they are selling bicycles for parents to teach their kids how to ride a bike without training wheels.

They are bicycles for two. You take the training wheels off, and then sit in the front seat and take your kid for a ride.

So, is it better to take the wheels off and let the kid learn how to ride a bike, or do you take the wheels off and still control the bike and they really don't learn to do it themselves.

Personal responsibility must eventually be personal.

Hey Petrous,

Everybody should eat ham sandwiches.

That statement to you means I've got religion? Preposterous.

My belief in helping my fellow man has nothing to do with religion. I simply feel that we are living the good life thanks to the benifits left to us by others. Without other people we would still be hunting bunnies living in a cave. So no matter if one person in particular has helped you or not you are still benifiting from others so pay it back.

In a finite world, MS should be treated, AIDS and diabetes should not. Sorry. Behavioral diseases will be getting the short stick.

Hope you libbies don't mind that.

AIDS and diabetes should not. Sorry. Behavioral diseases will be getting the short stick.

Guess you'll have to include cancer from smoking in that. Tell me, rightiswrong, does an AIDS baby get spared your eugenics wrath?

I'd like to see worth to society and morality be a determining factor if treatment would given or not. Obviously treatment for the most curable illnesses would be withheld from RIR since his value to society is 0.

AIDS babies, sure. Smokers, sorry. Fatties, sorry again. No money.

But this won't last more than a generation or so. Once we put the Baby Boomers into the ground, the country can regain its fiscal footing once more. But not until then. The "Me Generation" just has to go.

Tell me, rightiswrong, does an AIDS baby get spared your eugenics wrath?

Ummm that's not eugenics.

Behavioral diseases will be getting the short stick.

Great. What behaviors do you engage in that I get to decide means you don't get health treatment?

Skiing, rock climbing, mountain biking, whitewater rafting, surfing. All of which are safer than smoking, drinking beer, gay sex, Twinkies, joining a gang, or living in DC.

Dont forget bitter divorced guys. I don't want my health care dollars paying for those jagoffs.

Oh, I'm not bitter. Best thing that happened to me.

Them too, probably. No regrets anywhere.

Great. What behaviors do you engage in that I get to decide means you don't get health treatment?

#58 | Posted by jpw

If people were paying their own way, that question would never come up. It is only a problem when I have to pay your bills.

If people were paying their own way, that question would never come up. It is only a problem when I have to pay your bills.

Do you have insurance?

Then guess what, you're helping pay other people's bills.

For some reason I doubt you have enough money to pay for anything other than a minor hospital visit.